An Educational Day at the SCCA, Lesson 3: Food Beats Timing

The Xeloda needs to be taken twice a day, approximately twelve hours apart, and with food. I had been under the impression that the most important part of that instruction was the bit about the twelve hours. Consequently, to make sure that for the two weeks of pill taking I was always splitting the days equally in half, I take my pills at 9:00. Any earlier and I won't be reliably awake on the weekends, any later and there's a fair chance I may collapse into bed before I remember to take the pills.

This, of course, meant that my pill taking and eating were generally separated by an hour or two. My bad, Today I learned that it's the food part that's most important, If the doses are only separated by nine or ten hours (or, conversely, but fourteen or fifteen hours) that's not nearly as big a deal as having food in your stomach when you take them. 

But get this. The reason for this is that food gets in the way of the absorption of the drug. So when they calculate the dosage they're not only taking into account your general size,* but also how much of the drug won't be absorbed because of the food. 

Stupidly, I was so focused on being a good patient and agreeing to do what I was told, I forgot to ask the obvious question: if this drug is so toxic and so expensive, and food prevents its uptake, why don't you give me less of it and tell me to take it on any empty stomach? 

If I remember, that question I will ask my oncologist at our appointment in May.


* I couldn't tell if it was surface area or volume that they were most interested in here.